Purpose-This chapter discusses the promise of and challenges to providing effective and culturally responsive trauma-focused mental health services to immigrant and refugee youth and their families within school settings. Design/methodology/approach-This chapter utilizes "practice-based evidence" to outline successes and address the barriers associated with the implementation of school-based, trauma-focused, evidence-based interventions in four immigrant or refugee-dense cities: Los Angeles, Chicago, Minneapolis, and Boston. Findings-Making cultural adaptations to identified trauma interventions that were consistent with community priorities, cultural norms, and values resulted in more accessible programs and greater engagement in treatment services. Practical implications-The strategies tested in these real-world settings contribute to the development of culturally competent trauma-informed services for immigrant and refugee youth and their families. Mental health providers and program developers will better understand the need for multilevel engagement strategies and for culturally driven modifications when employing evidence-based programs with immigrant and refugee youth. Originality/value-This chapter adds to the scarce evidence about useful methods to engage immigrant and refugee youth and families in treatment and to increase the likelihood of positive outcomes.